Prospective Payment Coordinator, Inpatient Rehabilitation

American Addiction Centers • Winston-Salem, NC

8d • $36 - $53 • Onsite

About The Position

The Inpatient Rehabilitation program is seeking a full time PPS Coordinator to join the team. The PPS coordinator is responsible for promoting high quality, patient-centered care by providing clinical support in the prompt completion of the IRF Patient Assessment Instrument (IRF-PAI) to ensure accuracy in the score of functional status and reflection of the patient's care needs. The PPS coordinator works alongside the multidisciplinary team to expedite care and ensure data collection is completed, entered, and analyzed. Qualified applicants must have a strong focus on team communication and organization, flexibility and time management. Candidates with experience in IRF-PAI data management preferred but not required.

Requirements

• Bachelor's degree in Nursing, Physical Therapy, Occupational Therapy, or Speech Therapy with three years' clinical/administrative experience in Inpatient Rehabilitation required.
• Credential Primary Source Verification required.
• Licensed in Nursing, Physical Therapy, Occupational Therapy, or Speech Therapy by the State of applicable state required.
• CPR certification required.
• MOAB (Management of Aggressive Behavior) certification required

Nice To Haves

• Candidates with experience in IRF-PAI data management preferred but not required.

Responsibilities

• Assessment Admin - Establishes and maintains a schedule for timely completion of all admission and discharge patient assessment instruments. Ensures completion of the patient assessment instrument and supporting documentation within established timeframes. Performs/oversees accurate entry and coding of data. Performs/oversees electronic data transmission to CMS and Uniform Data System for Medical Rehabilitation (UDSMR) within established timeframes. Performs credentialing on the FIM Instrument and Quality Indicators as required by UDSMR. Reviews admission and discharge assessment data and supporting clinical documentation to validate the data on the patient assessment instrument. Recognizes variances in documentation and collaborates with interdisciplinary team members to ensure accuracy of documentation.
• Communication - Communicates schedule for completion of patient assessment instruments to manager and billing department including CMG and date of transmission. Communicates expected Case Mix Group (CMG) and targeted length of stay based upon the admission patient assessment instrument to the interdisciplinary team at team conference.
• Teamwork - Collaborates with interdisciplinary team members to ensure accuracy of data. Provides clinical expertise by collaborating with members of the interdisciplinary team. Follows up with interdisciplinary team members as needed related to the accuracy or timeliness of documentation/data and provides feedback to manager as indicated. Provides feedback to interdisciplinary team members on the clinical and financial management of Medicare patients in particular. Attends team conferences to identify additional coding opportunities. Assists Admissions Coordinator with IRC referrals and admissions process as needed and serves as back-up in his/her absence.
• Billing Audits - Completes quarterly billing audits to determine accuracy of dates of service and to ensure that what was billed matches the services provided.
• Customer Focus - Responsible for maintaining excellent rapport with all managed care company personnel and enhancing the work relationship as necessary. Communicates with managed care/insurance company personnel in a professional manner.
• Compliance - Keeps abreast of regulatory or other changes that impact the IRF-PAI or UDSMR outcomes management system. Demonstrates knowledge and understanding of CARF standards and assists management with ongoing CARF preparation as requested. Attends conferences on a regular basis to ensure continued compliance with regulatory requirements, coding and billing requirements, and FIM requirements. Completes quarterly documentation audits to ensure compliance with regulatory requirements.
• Reporting - Independently manipulates UDSMR outcomes management system to regularly generate and retrieve routine and on-demand reports for manager/director in order to assist in supporting decision making, process improvement, etc. Analyzes report information and identifies trends. Makes recommendations for process improvements as indicated.
• Training & Education - Provides ongoing education to interdisciplinary team on the IRF-PAI and UDSMR outcomes management system, including providing in-services as needed to clarify issues or address variances and providing one-on-one coaching to improve the quality of data to maximize reimbursement and ensure accurate documentation of outcomes. Provides orientation on the IRF-PAI and the UDSMR outcomes management system to all new employees. Provides for staff training on the IRF-PAI, FIM Instrument, and QI as required by UDSMR.
• Professionalism - Upholds a professional working relationship at all times and adheres to department rules. Practices teamwork and adheres to Standards of Behavior. Performs other duties as assigned by management.

Benefits

• Day 1 Health Coverage: Choose from either copay or HSA-eligible health insurance options with coverage starting on your first day of work.
• Generous PTO: Accrual starts at up to 25 days/year, to be used for vacations, sickness, holidays, and personal matters.
• Parental Benefits: Six weeks paid birthing-mother maternity leave & four weeks paid parental leave for non-birthing parents.
• Retirement: Up to 7% employer-paid retirement contributions
• Education Reimbursement: We invest in your professional growth, offering up to $2,500 per year towards a bachelor's degree and up to $5,000 per year towards a graduate degree.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level